PDF(Pubmed)
Abstract：
BACKGROUND: Dry needling is an intervention used by physiotherapists to manage muscle spasticity. We report the effects of three sessions of dry needling on ankle plantar flexor muscle spasticity and cortical excitability in a patient with multiple sclerosis.
METHODS: The patient was a 40-year-old Iranian woman with an 11-year history of multiple sclerosis. The study outcomes were measured by the modified modified Ashworth scale, transcranial magnetic stimulation parameters, and active and passive ankle range of motion. They were assessed before (T0), after three sessions of dry needling (T1), and at 2-week follow-up (T2). Our result showed: the modified modified Ashworth scale was improved at T2 from, 2 to 1. The resting motor threshold decreased from 63 to 61 and 57 at T1 and T2, respectively. The single test motor evokes potential increased from 76.2 to 78.3. The short intracortical inhibition increased from 23.6 to 35.4 at T2. The intracortical facilitation increased from 52 to 76 at T2. The ankle active and passive dorsiflexion ROM increased ~ 10° and ~ 6° at T2, respectively.
CONCLUSIONS: This case study presented a patient with multiple sclerosis who underwent dry needling of ankle plantar flexors with severe spasticity, and highlighted the successful use of dry needling in the management of spasticity, ankle dorsiflexion, and cortical excitability. Further rigorous investigations are warranted, employing randomized controlled trials with a sufficient sample of patients with multiple sclerosis. Trial registration IRCT20230206057343N1, registered 9 February 2023, https://en.irct.ir/trial/68454.
METHODS: The patient was a 40-year-old Iranian woman with an 11-year history of multiple sclerosis. The study outcomes were measured by the modified modified Ashworth scale, transcranial magnetic stimulation parameters, and active and passive ankle range of motion. They were assessed before (T0), after three sessions of dry needling (T1), and at 2-week follow-up (T2). Our result showed: the modified modified Ashworth scale was improved at T2 from, 2 to 1. The resting motor threshold decreased from 63 to 61 and 57 at T1 and T2, respectively. The single test motor evokes potential increased from 76.2 to 78.3. The short intracortical inhibition increased from 23.6 to 35.4 at T2. The intracortical facilitation increased from 52 to 76 at T2. The ankle active and passive dorsiflexion ROM increased ~ 10° and ~ 6° at T2, respectively.
CONCLUSIONS: This case study presented a patient with multiple sclerosis who underwent dry needling of ankle plantar flexors with severe spasticity, and highlighted the successful use of dry needling in the management of spasticity, ankle dorsiflexion, and cortical excitability. Further rigorous investigations are warranted, employing randomized controlled trials with a sufficient sample of patients with multiple sclerosis. Trial registration IRCT20230206057343N1, registered 9 February 2023, https://en.irct.ir/trial/68454.
摘要：
背景：干针是物理治疗师用来控制肌肉痉挛的一种干预措施。我们报告了三个疗程的干针法对多发性硬化症患者的踝足屈肌痉挛和皮质兴奋性的影响。
方法：患者是一名40岁的伊朗妇女，有11年的多发性硬化症病史。研究结果由改良的改良Ashworth量表测量，经颅磁刺激参数,以及主动和被动的踝关节运动范围。他们之前进行了评估（T0），干针刺三次后（T1），和2周随访（T2）。我们的结果表明：改良后的Ashworth量表在T2时有所改善，2到1。静止电机阈值在T1和T2分别从63降低到61和57。单个测试电机的电位从76.2增加到78.3。在T2时，短皮质内抑制从23.6增加到35.4。在T2时，皮质内促进从52增加到76。踝关节主动背屈ROM和被动背屈ROM在T2时分别增加~10°和~6°。
结论：本病例研究介绍了一名多发性硬化症患者，该患者因严重痉挛而对踝关节足底屈肌进行了干针刺，并强调了干针法在痉挛管理中的成功应用，踝关节背屈,和皮质兴奋性。需要进一步严格的调查，采用具有足够的多发性硬化症患者样本的随机对照试验。试用注册IRCT20230206057343N1，注册于2023年2月9日，https://en。irct.ir/trial/68454。
方法：患者是一名40岁的伊朗妇女，有11年的多发性硬化症病史。研究结果由改良的改良Ashworth量表测量，经颅磁刺激参数,以及主动和被动的踝关节运动范围。他们之前进行了评估（T0），干针刺三次后（T1），和2周随访（T2）。我们的结果表明：改良后的Ashworth量表在T2时有所改善，2到1。静止电机阈值在T1和T2分别从63降低到61和57。单个测试电机的电位从76.2增加到78.3。在T2时，短皮质内抑制从23.6增加到35.4。在T2时，皮质内促进从52增加到76。踝关节主动背屈ROM和被动背屈ROM在T2时分别增加~10°和~6°。
结论：本病例研究介绍了一名多发性硬化症患者，该患者因严重痉挛而对踝关节足底屈肌进行了干针刺，并强调了干针法在痉挛管理中的成功应用，踝关节背屈,和皮质兴奋性。需要进一步严格的调查，采用具有足够的多发性硬化症患者样本的随机对照试验。试用注册IRCT20230206057343N1，注册于2023年2月9日，https://en。irct.ir/trial/68454。
